EP1033941A2 - Surgical implant and surgical fixing screw - Google Patents

Surgical implant and surgical fixing screw

Info

Publication number
EP1033941A2
EP1033941A2 EP98955808A EP98955808A EP1033941A2 EP 1033941 A2 EP1033941 A2 EP 1033941A2 EP 98955808 A EP98955808 A EP 98955808A EP 98955808 A EP98955808 A EP 98955808A EP 1033941 A2 EP1033941 A2 EP 1033941A2
Authority
EP
European Patent Office
Prior art keywords
surgical
head
fixing screw
implant
shank
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
EP98955808A
Other languages
German (de)
French (fr)
Other versions
EP1033941B1 (en
Inventor
Philip Hobson Hardcastle
Duncan Robert Keeble
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Surgicraft Ltd
Original Assignee
Surgicraft Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from GBGB9725259.7A external-priority patent/GB9725259D0/en
Priority claimed from GBGB9725258.9A external-priority patent/GB9725258D0/en
Application filed by Surgicraft Ltd filed Critical Surgicraft Ltd
Publication of EP1033941A2 publication Critical patent/EP1033941A2/en
Application granted granted Critical
Publication of EP1033941B1 publication Critical patent/EP1033941B1/en
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B17/8685Pins or screws or threaded wires; nuts therefor comprising multiple separate parts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/686Plugs, i.e. elements forming interface between bone hole and implant or fastener, e.g. screw
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7059Cortical plates
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8033Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
    • A61B17/8042Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers the additional component being a cover over the screw head
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30721Accessories
    • A61F2/30724Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442Intervertebral or spinal discs, e.g. resilient
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/28Bones
    • A61F2002/2835Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/3011Cross-sections or two-dimensional shapes
    • A61F2002/30112Rounded shapes, e.g. with rounded corners
    • A61F2002/30131Rounded shapes, e.g. with rounded corners horseshoe- or crescent- or C-shaped or U-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30579Special structural features of bone or joint prostheses not otherwise provided for with mechanically expandable devices, e.g. fixation devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604Special structural features of bone or joint prostheses not otherwise provided for modular
    • A61F2002/30616Sets comprising a plurality of prosthetic parts of different sizes or orientations
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772Apertures or holes, e.g. of circular cross section
    • A61F2002/30784Plurality of holes
    • A61F2002/30787Plurality of holes inclined obliquely with respect to each other
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772Apertures or holes, e.g. of circular cross section
    • A61F2002/3079Stepped or enlarged apertures, e.g. having discrete diameter changes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2002/449Joints for the spine, e.g. vertebrae, spinal discs comprising multiple spinal implants located in different intervertebral spaces or in different vertebrae
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004Rounded shapes, e.g. with rounded corners
    • A61F2230/0013Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • A61F2310/00017Iron- or Fe-based alloys, e.g. stainless steel
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • A61F2310/00023Titanium or titanium-based alloys, e.g. Ti-Ni alloys
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389The prosthesis being coated or covered with a particular material
    • A61F2310/00592Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
    • A61F2310/00796Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite

Definitions

  • the present invention relates, in a first aspect, to a surgical implant for use with a bone graft between vertebrae, more particularly cervical vertebrae, in order to fuse said vertebrae, to a system comprising said implant and to a method of facilitating the fusion of adjacent vertebrae using said system.
  • the present invention also relates, in a second aspect, to a surgical fixing screw which may be used for surgical applications generally, but which is particularly suitable for use with the surgical implant according to the first aspect of the invention.
  • the disc in certain spinal disorders, such as degenerative disease of the intervertebral substance (hereinafter simply referred to as "disc"), it is necessary for the disc to be removed and the neighbouring vertebrae to be fused, aided by a bone graft inserted between the vertebrae. Inevitably, the fusion process is slow, and it is desirable for the bone graft and vertebrae to be immobilised for fusion to take place with the vertebrae and graft correctly positioned.
  • Cervical Spine Locking Plate System One solution (exemplified by the so-called Cervical Spine Locking Plate System, available from Synthes) is to insert the bone graft between the vertebrae and then secure the vertebrae to each other by means of a metal plate which lies along one face (generally the anterior face) of the vertebrae.
  • the plate is held in place against the vertebrae by fixing screws which pass through holes provided in the plate and which are screwed into holes drilled into the vertebrae.
  • the bone graft is maintained in position by compressive forces. In use, however, such a plate can be difficult to align properly.
  • a metal plate is integrally formed with a metal ring which protrudes perpendicularly from the midpoint of the plate.
  • the plate can be supplied with a disc of hydroxy- apatite bone substitute fixed in the region enclosed by the ring.
  • the ring containing the hydroxy-apatite disc is inserted between the vertebrae which presents the metal plate in the correct alignment for securing to the vertebrae by means of fixing screws.
  • the plate is supplied without the disc of hydroxy-apatite and the surgeon prepares the bone graft. Difficulties arise if it is necessary to remove the plate, since the entire bone graft will also be removed, requiring the whole procedure to be repeated.
  • the latter system is not suitable for fusing three adjacent vertebrae.
  • a surgical implant comprising:-
  • a body portion having first and second passages therethrough, said passages being adapted and disposed in said body portion so as to be capable of receiving a securing element (e.g. a screw) for securing said implant to first and second adjacent vertebrae (eg cervical vertebrae) respectively; and
  • a securing element e.g. a screw
  • first and second mutually spaced arms carried by and extending away from said body portion; wherein said arms are adapted so as to be capable of insertion between said first and second adjacent vertebrae, and wherein at least part of said body portion is adapted to engage with anterior faces of both adjacent vertebrae when said arms are located between said adjacent vertebrae, so that, in use, a bone graft can be held in position between the first and second arms and between mutually facing superior and inferior surfaces of said first and second adjacent vertebrae.
  • the body portion of the implant is constructed such that when the arms of the implant are located between said first and second adjacent vertebrae, another implant can be secured to the anterior face of one of the first and second adjacent vertebrae and a third vertebra, said third vertebra being adjacent to the same one of said first or second adjacent vertebrae.
  • the arms are preferably straight and preferably also mutually parallel.
  • each arm is roughened and/or provided with a hydroxy-apatite coating.
  • said surfaces will be in contact with the facing superior and inferior surfaces of the adjacent vertebrae.
  • the roughened surface and/or hydroxy-apatite coating encourages in-growth of bone, thereby providing additional securement of the implant.
  • the body portion may be provided with more than two passages. Most preferably three or four passages are provided. At least one passage preferably has its axis inclined to the arms. More preferably, at least said first and said second passages have mutually inclined axes.
  • the implant is of a unitary construction of biocompatible material.
  • suitable materials include titanium, titanium alloy and stainless steel.
  • a method of fusing adjacent vertebrae comprising the steps of:-
  • the method may be extended to the fusion of a third vertebra, said third vertebra being adjacent to one of said first and second adjacent vertebrae, in which case the above steps are repeated with respect to the first and third vertebrae or the second and third vertebrae using another surgical implant.
  • said securing elements are fixing screws of which at least one may be a surgical fixing screw according to said second aspect of the present invention.
  • said second aspect of the present invention it is an objection to provide a design of surgical fixing screw which enables a secure fixing of a part such as an implant to take place with a reduced risk of disengagement from such part.
  • a surgical fixing screw including a head and a screw-threaded shank, wherein the head is formed so that it can be transformed between a laterally expanded condition and a laterally contracted condition.
  • laterally means laterally relative to the longitudinal axis of the shank.
  • the head is formed so that it can be transformed between a radially expanded condition and a radially contracted condition.
  • the surgical fixing screw further includes retaining means engageable within the head for preventing the head from being transformed into its laterally contracted condition.
  • the surgical fixing screw When in its laterally contracted condition, the surgical fixing screw can be inserted within an aperture in the part to be secured. When in its outwardly extended condition, the head of the surgical fixing screw enables fixing of the screw within the aperture in the part in a manner such as to reduce the risk of disengagement of the surgical fixing screw from the part.
  • the head is shaped so that, in its laterally expanded condition, it projects laterally into an undercut recess in the part whereby the head is prevented from disengagement from the part by interlocking with the latter.
  • the head of the surgical fixing screw has a recess therein in which the retaining means is engageable so that the retaining means engages a wall of the recess to prevent the head from being transformed into its laterally compressed condition.
  • a surgical fixing screw comprising a head and an externally screw-threaded shank which is divided longitudinally into lateral wings which are capable of being deformed outwardly of the longitudinal axis of the shank. This obviates or mitigates the risk of the screw becoming detached from, or loosened in, a hole in bone or hard tissue in which the screw shank is engaged in use.
  • the shank is adapted to receive an expansion means which, during insertion into the fixing screw, causes the outward deformation of the wings.
  • the body of the shank tapers inwardly away from the head.
  • the expansion means is held within the shank by means of a complementary thread arrangement.
  • the expansion means for causing outward deformation of the wings and the retaining means for the head are provided as different parts of a single retaining and expansion element engageable with the shank and the head of the screw.
  • the surgical fixing screw is constructed and adapted for use in the securing of a surgical implant in position.
  • the head of the screw may have a first formation for engagement, in use, by a screwdriver and a second formation, spatially distinct from the first formation, for engagement, in use, by an alternative screwdriver.
  • the screw can be removed subsequently using the other screwdriver on the other of the first and second formations.
  • said first and second formations are spaced apart longitudinally in the axis of rotation of the surgical fixing screw.
  • Fig 1 is a perspective view of a surgical implant in accordance with said first aspect of the present invention.
  • Fig 2 is a plan view of the surgical implant shown in Fig 1 ;
  • Fig 3 is an end-on view of the surgical implant shown in Fig 1 ;
  • Fig 4 is a cross-sectional view of the surgical implant shown in Fig 1 ;
  • Fig 5 is a schematic illustration showing the attachment of two surgical implants according to the present invention to a single cervical vertebra
  • Fig 6 is a side view of an example of a surgical fixing screw according to said second aspect of the present invention.
  • Fig 7 is a axial section through the surgical fixing screw of Fig 6;
  • Fig 8 is a perspective view of the surgical fixing screw of Figs 6 and 7;
  • Fig 9 is an end view of the head of the surgical fixing screw of Figs 6 to 8;
  • Fig 10 is a side view of an expansion element for use in the fixing screw of
  • Fig 1 1 is a plan view similar to Fig 2 of another embodiment of surgical implant;
  • Fig 12 is a side view of the implant of Fig 11 ;
  • Fig 13 is an axial section through an embodiment of surgical fixing screw for use with the implant of Figs 1 1 and 12;
  • Fig 14 is a perspective view of the surgical fixing screw of Fig 13;
  • Fig 15 is an axial section showing the surgical fixing screw of Figs 13 and
  • Fig 16 is a detail showing the interengagement between the screw of Fig
  • Fig 1 7 is a view showing the use of the implant of Figs 1 1 and 12 and surgical fixing screws of Figs 13 to 15 to secure two cervical vertebrae together.
  • the surgical implant 2 is U-shaped and comprises a curved flange-like body portion 4 having a posterior major surface 6a, an anterior major surface 6b, a superior edge surface 8a and an inferior edge surface 8b, and a pair of mutually spaced, parallel straight arms 10.
  • the implant 2 is of unitary construction and, in this embodiment, is made from titanium alloy (complying with BS7252 PT3 1990).
  • a respective one of the arm 10 extends away from the body portion 4. The depth of the arms 10 (i.e.
  • each arm 10 is roughened and provided with a hydroxy- apatite coating (not shown).
  • the body portion 4 is provided with two pairs of identical passages 16a and 16b which extend through the body portion 4 from the posterior major surface 6a to the anterior major surface 6b of the body portion 4.
  • the passages 16a are spaced apart along the body portion 4 at a distance from the superior edge surface 8a of the body portion 4, while the passages 16b are at the same distance from the inferior edge surface 8b of the body portion 4 and offset relative to the first passages 16a.
  • Each passage 16a, 16b comprises anterior and posterior coaxial cylindrical regions 18a,18b of different diameters such that an annular step 20, which serves as a seat for a fixing screw, is defined at their intersection.
  • the axis of each of the passages 16a is inclined above the direction of extent of the arms 10 by 10°.
  • the axis of each of the passages 16b is inclined below the direction of extent of the arms 10 by 10°.
  • the surgical implant 2 may be used in an operation where, for whatever reason, it is necessary to replace the intervertebral disc between a pair of adjacent cervical vertebrae by a bone graft.
  • the disc or fragments thereof
  • the inferior surface of a first (superior) disc and the superior surface of an adjacent second (inferior) disc are prepared for the reception of a bone graft.
  • Bone graft material is compacted between the vertebrae and the arms 10 of the implant 2 are pushed between the vertebrae, either side of the bone graft material, from the anterior side of the vertebrae.
  • the respective regions of the posterior major surface 6a abut the anterior surfaces of the first and second vertebra.
  • the arms 10 of the implant 2 are located between the vertebrae ensures that there is no error in the alignment of the implant 2 before it is fixed in place.
  • Such fixing is achieved by forming holes in the vertebrae using the passages 16 in the body portion 4 as guides, followed by inserting expanding surgical fixing screws, for example surgical fixing screws 100 as described below, through each passage 16a,16b in the body portion 4 and into the respective vertebra.
  • expanding surgical fixing screws for example surgical fixing screws 100 as described below
  • the offset positioning of the passages 16a, 16b ensures that the screws used to fix the respective first and second implants do not interfere with each other.
  • Fig 5 where it can be seen that the design of the implant is such that two identical implants 2a and 2b can be secured to a single vertebra V using the two intermediate pairs of screws 100 which are mutually offset because of the positioning of the passages 16a,16b.
  • the vertebrae (not shown in Fig 5) which are adjacent to the illustrated vertebra V will be respectively secured by upper and lower pairs of screws 100 illustrated in Fig. 5.
  • Each surgical fixing screw 100 is tightened until the head of the screw is seated against the annular step 20, at which point the vertebrae are securely fixed relative to each other.
  • the fixing in place of the implant 2 is enhanced by the inclination of the passages 16 in the body portion 4, which makes it more difficult for the implant 2 to work loose than if the passages 16a, 16b were mutually parallel or parallel to the direction of extent of the arms 10.
  • the expanding nature of the screws 100 also assists in ensuring a secure fixing of the implant in place.
  • the roughened and hydroxy-apatite coated superior and inferior surfaces 12a, 12b encourage in-growth of bone on those surfaces 12a, 12b of the arms 10 only.
  • the implant 2 In the above-described procedure, it is generally intended for the implant 2 to remain permanently in place, however, there may be circumstances in which it is necessary for it to be removed. Should this be necessary, the implant 2 can be withdrawn by unscrewing the screws 100 and withdrawing the implant. Clearly, any bonding between the upper and lower surfaces 12a, 12b of the arms with the vertebrae must be broken, but the bone graft between the arms 10 will remain intact. Thus, replacement or permanent removal of the implant 2 can be achieved without requiring a second bone graft.
  • the surgical fixing screw 100 comprises two parts, a shank 101 and a head 102.
  • the shank 101 has an exterior screw thread 103 such that the body of the shank 101 decreases in diameter away from the head 102.
  • the flight 104 of the screw thread 103 is, however, of constant diameter over the region AB, decreasing in diameter in only the terminal turn adjacent A.
  • the flight 104 has a flat crest which increases in width towards the head 102 over the region AB.
  • a passage 105 extends longitudinally throughout the length of the fixing screw 100.
  • Two diametrically opposed slots 106 extend radially inwardly from the peripheral surface of the shank 101 to communicate with the passage 105.
  • the slots 106 and passage 105 extend over the length of the shank 101 so as to divide the latter longitudinally into two lateral wings 107.
  • the passage 105 comprises three parts, a tapered end region 108, an intermediate screw-threaded region 109 and a head end region 120.
  • the head end region 120 defines an internal recessed hexagonal formation 121 which opens onto the head end of the screw 100 and which , in use, engagingly receives a screwdriver having a hexagonal bit (not shown).
  • a step 122 is defined at the junction between the regions 109 and 120 which are situated within the head 102 of the screw 100.
  • the step 122 faces the head end of the screw and has a cross-recessed formation 123 therein which, in use, engagingly receives another screwdriver having a cross-headed bit (not shown).
  • the formations 121 and 123 are spatially distinct (in this embodiment, they are spaced apart along the longitudinal axis of the screw) and are independently engageable by the respective screwdrivers.
  • the screw-threaded region 109 is adapted to receive an expansion element 124 (Fig 10) which will be described later.
  • the tapered end region 108 of the passage 105 tapers inwardly away from the intermediate screw-threaded region 109 and extends over the whole of the length of the shank 101.
  • the head 102 has an outer peripheral surface 126 provided with a radial lip 127 so as to form an abutment shoulder 128 for engagement, in use, against the step 20 described above.
  • the expansion element 124 comprises a head region 130, an intermediate externally screw-threaded region 131 and a rod-like region 132.
  • the head region 130 has a slot 133 for cooperative engagement by a further screwdriver bit.
  • the intermediate screw-threaded region 131 is engageable with the internal screw-threaded region 109 such that the expansion element 124 can be fixed within the passage 105.
  • the rod-like region 132 projects from the threaded region 131 and has a diameter larger than the minimum diameter of the tapered region 108.
  • a borehole is drilled in the latter and the screw 100 is secured in the borehole by rotating it using the hexagonal or cross-recessed formations 121 or 123 with the appropriate screwdriver. Then, the expansion element 124 is inserted into the screw 100 and is rotated using the further screwdriver bit engaged in the slot 133.
  • the fixing screw 100 can be extracted from the bone, after removal of the expansion element 124, by use of a suitable screw driver engaged with either of the formations 121 , 123.
  • a suitable screw driver engaged with either of the formations 121 , 123.
  • This allows the option of choosing one specific formation 121 or 123 should the alternative formation 123 or 121 become damaged or otherwise unserviceable.
  • This choice is especially advantageous as the lateral wings 107 will remain deformed after the removal of the expansion member 124 and therefore an effective engagement of the screwdriver with the chosen formation is essential.
  • the above described surgical fixing screw 100 may be used for other surgical applications.
  • the surgical implant 2 is, like that of Figs 1 to 5, for fusing adjacent cervical vertebrae together, and similar parts are accorded the same reference numerals.
  • the arms 10 are not disposed at opposite lateral ends of curved flange-like body portion 4 but are spaced slightly inwardly of the ends.
  • the superior and inferior surfaces of the arms 10 are not mutually parallel but are mutually tapered. This tapering is chosen so as to restore and/or maintain cervical lordosis (natural curvature of the spine).
  • the lateral surfaces of the arms 10 are, however, mutually parallel as in the case of the embodiment of Figs 1 to 4.
  • a variety of implants 2 of different size may be provided with the arms 10 available in varying heights and widths to fit different anatomies.
  • Notches 17 are provided in the ends (lateral faces) of the body portion 4 and on the free ends (posterior faces) of the arms 10. These notches 17 enable the surgeon to tie a suture around the implant in order to hold the bone graft in position during insertion.
  • the superior and inferior faces of the body portion 4 are formed with complementary recesses and lugs to enable adjacent implants to be stacked closely together.
  • the implant 2 has two superior apertures 16a and one inferior aperture 16b.
  • surgical fixing screw 100 is similar to that of Figs 6 to 10 and similar parts are accorded the same reference numerals.
  • head 102 has a series of four equi-angularly spaced slots 140 extending from the outside of the head 102 to open into the head end region 120 of the passage 105. These slots 140 permit the head to be transformed between a laterally relatively expanded condition as illustrated in Figs 14, 15 and 16 and a laterally relatively contracted condition (not shown). These slots 140 also enable a screwdriver with a cross-headed bit to be engaged with the head 102 of the screw 100.
  • Internal recessed hexagonal formation 121 in this embodiment, is disposed within the region of the shank 101 adjacent the head 102 rather than within the latter.
  • the passage 105 does not extend over the full length of the shank 101 but terminates at a conical end wall spaced from the free end of the shank.
  • the slots 106 extend over part of the length portion 108 of the passage 105 to the free end of the shank 101.
  • the portion 108 of the passage 105 is not tapered but is parallel sided.
  • the head region 130 of the expansion element 124 comprises an inwardly tapering frusto-conical head portion 130a and a cylindrical head portion 130b.
  • the frustum of the head portion 130a has a larger diameter than the adjacent head portion 130b so that a step 130c is defined between these two portions.
  • the head portion 130b is of a size such that it is rotatable with clearance within the hexagonal formation 121.
  • the base of the frusto-conical head portion 130a is equal in diameter to that of the head end region 120 of the passage 105 when the head is in its laterally expanded condition.
  • each passage 16a or 16b has a diameter which is slightly less than that of the radial lip 127. Adjacent to the anterior region 18a of the passage 16, there is an undercut annular recess 150 following which the posterior region 18b of the passage 16 is provided.
  • the posterior region 18b has a diameter which is marginally greater than the outer diameter of the head 102 of the screw 100.
  • each fixing screw 100 is inserted through the respective aperture 16a or 16b and rotated to cause it to advance into the hole in the cervical vertebra until the lip 127 engages against the body portion 4 around the anterior end of the passage 16. Because the lip 127 is curved, the head 102 is deformed radially inwardly into its laterally contracted condition as permitted by the partial closure of the slots 140. This allows the lip 127 to pass through the anterior region 18a and into the recess 150.
  • the head 102 When it reaches the recess 150, the head 102 is free to spring outwardly so that the lip 127 extends into the recess 150, thereby providing an interlock to prevent unwanted disengagement of the lip 127 from the undercut recess 150.
  • the screw 100 can then be fully tightened to urge the implant against the cervical vertebrae.
  • the expansion element 124 is inserted into the screw 100 and rotated so as to cause the wings of the screw to be expanded outwardly to anchor the screw within the hole drilled in the cervical vertebra.
  • the head region 130 of the expansion element 124 enters the recess 120 fully and serves to retain the head 102 against being compressed radially inwardly.
  • the head portion 130a may also serve to urge the head portion 102 outwardly if any permanent deformation of the head of the screw has taken place as a result of the lip 127 being forced through the smaller diameter anterior region 18a of the passage 16. In this way, the screw 100 is securely interlocked with the body portion 4 of the surgical implant 2.
  • Fig 17 shows the arrangement where three screws 100 are used to secure the surgical implant 2 in position, with two of the screws being engaged with the upper cervical vertebra V and one screw being engaged with the lower cervical vertebra V of the pair to be fused together.
  • the superior and inferior faces of the body portion 4 of the implant 2 are suitably shaped with a lug and recess arrangement to enable each portion 4 to be nested closely with the body portion(s) 4 of adjacent implant(s) 2.

Abstract

A surgical implant (2) for fusing adjacent vertebrae (V) together comprises a body portion (4) with spaced arms (10). The body portion (4) has passages (16a and 16b) to receive surgical fixing screws (100) engaged in holes drilled in the vertebrae (V) for securing the body portion (4) to the anterior faces of the vertebrae (V) to be fused. The arms (10) extend into a prepared space between the vertebrae to be fused. Graft material is packed between the arms (10). Each surgical fixing screw (100) has an externally screw-threaded shank (101) divided into wings which can be outwardly deformed to anchor the shank (101) in the hole. Each surgical fixing screw (100) also had a head (102) which can be transformed between a laterally expanded condition and a laterally contracted condition to permit the head to be interlocked with the implant (2).

Description

SURGICAL IMPLANT AND SURGICAL FIXING SCREW
The present invention relates, in a first aspect, to a surgical implant for use with a bone graft between vertebrae, more particularly cervical vertebrae, in order to fuse said vertebrae, to a system comprising said implant and to a method of facilitating the fusion of adjacent vertebrae using said system.
The present invention also relates, in a second aspect, to a surgical fixing screw which may be used for surgical applications generally, but which is particularly suitable for use with the surgical implant according to the first aspect of the invention.
With regard to said first aspect of the present invention, in certain spinal disorders, such as degenerative disease of the intervertebral substance (hereinafter simply referred to as "disc"), it is necessary for the disc to be removed and the neighbouring vertebrae to be fused, aided by a bone graft inserted between the vertebrae. Inevitably, the fusion process is slow, and it is desirable for the bone graft and vertebrae to be immobilised for fusion to take place with the vertebrae and graft correctly positioned.
One solution (exemplified by the so-called Cervical Spine Locking Plate System, available from Synthes) is to insert the bone graft between the vertebrae and then secure the vertebrae to each other by means of a metal plate which lies along one face (generally the anterior face) of the vertebrae. The plate is held in place against the vertebrae by fixing screws which pass through holes provided in the plate and which are screwed into holes drilled into the vertebrae. The bone graft is maintained in position by compressive forces. In use, however, such a plate can be difficult to align properly. In another system (Fournitures Hospital ieres) a metal plate is integrally formed with a metal ring which protrudes perpendicularly from the midpoint of the plate. The plate can be supplied with a disc of hydroxy- apatite bone substitute fixed in the region enclosed by the ring. The ring containing the hydroxy-apatite disc is inserted between the vertebrae which presents the metal plate in the correct alignment for securing to the vertebrae by means of fixing screws. Alternatively, the plate is supplied without the disc of hydroxy-apatite and the surgeon prepares the bone graft. Difficulties arise if it is necessary to remove the plate, since the entire bone graft will also be removed, requiring the whole procedure to be repeated.
The latter system is not suitable for fusing three adjacent vertebrae.
It is an object of the first aspect of the present invention to provide a surgical implant which facilitates the fusion of adjacent cervical vertebrae, and obviates or mitigates the above-mentioned problems.
According to said first aspect of the present invention, there is provided a surgical implant comprising:-
(i) a body portion having first and second passages therethrough, said passages being adapted and disposed in said body portion so as to be capable of receiving a securing element (e.g. a screw) for securing said implant to first and second adjacent vertebrae (eg cervical vertebrae) respectively; and
(ii) first and second mutually spaced arms carried by and extending away from said body portion; wherein said arms are adapted so as to be capable of insertion between said first and second adjacent vertebrae, and wherein at least part of said body portion is adapted to engage with anterior faces of both adjacent vertebrae when said arms are located between said adjacent vertebrae, so that, in use, a bone graft can be held in position between the first and second arms and between mutually facing superior and inferior surfaces of said first and second adjacent vertebrae.
Preferably, the body portion of the implant is constructed such that when the arms of the implant are located between said first and second adjacent vertebrae, another implant can be secured to the anterior face of one of the first and second adjacent vertebrae and a third vertebra, said third vertebra being adjacent to the same one of said first or second adjacent vertebrae.
The arms are preferably straight and preferably also mutually parallel.
Preferably, upper and lower surfaces of each arm are roughened and/or provided with a hydroxy-apatite coating. In use, said surfaces will be in contact with the facing superior and inferior surfaces of the adjacent vertebrae. The roughened surface and/or hydroxy-apatite coating encourages in-growth of bone, thereby providing additional securement of the implant.
The body portion may be provided with more than two passages. Most preferably three or four passages are provided. At least one passage preferably has its axis inclined to the arms. More preferably, at least said first and said second passages have mutually inclined axes.
Preferably, the implant is of a unitary construction of biocompatible material. Examples of suitable materials include titanium, titanium alloy and stainless steel. Also according to said first aspect of the present invention, there is provided a system for fusing adjacent vertebrae (eg cervical vertebrae), said system comprising at least one surgical implant in accordance with said first aspect, at least one bone graft and securing elements for securing the implant to adjacent vertebrae.
Also according to said first aspect of the present invention, there is provided a method of fusing adjacent vertebrae (eg cervical vertebrae) comprising the steps of:-
(i) introducing bone graft material between first and second adjacent vertebrae,
(ii) locating the arms of a surgical implant in accordance with said first aspect around said bone graft material and between said adjacent vertebrae,
(iii) securing at least one securing element into the first vertebra, and
(iv) securing at least one securing element into the second vertebra, wherein each securing element passes through a respective one of said passages in the body portion of the implant.
The method may be extended to the fusion of a third vertebra, said third vertebra being adjacent to one of said first and second adjacent vertebrae, in which case the above steps are repeated with respect to the first and third vertebrae or the second and third vertebrae using another surgical implant.
Preferably, said securing elements are fixing screws of which at least one may be a surgical fixing screw according to said second aspect of the present invention. With regard to said second aspect of the present invention, it is an objection to provide a design of surgical fixing screw which enables a secure fixing of a part such as an implant to take place with a reduced risk of disengagement from such part.
According to said second aspect of the present invention, there is provided a surgical fixing screw including a head and a screw-threaded shank, wherein the head is formed so that it can be transformed between a laterally expanded condition and a laterally contracted condition.
The term "laterally" means laterally relative to the longitudinal axis of the shank. Preferably, the head is formed so that it can be transformed between a radially expanded condition and a radially contracted condition.
Preferably, the surgical fixing screw further includes retaining means engageable within the head for preventing the head from being transformed into its laterally contracted condition.
When in its laterally contracted condition, the surgical fixing screw can be inserted within an aperture in the part to be secured. When in its outwardly extended condition, the head of the surgical fixing screw enables fixing of the screw within the aperture in the part in a manner such as to reduce the risk of disengagement of the surgical fixing screw from the part.
In a preferred embodiment, the head is shaped so that, in its laterally expanded condition, it projects laterally into an undercut recess in the part whereby the head is prevented from disengagement from the part by interlocking with the latter. Preferably, the head of the surgical fixing screw has a recess therein in which the retaining means is engageable so that the retaining means engages a wall of the recess to prevent the head from being transformed into its laterally compressed condition.
Also according to said second aspect of the invention, there is provided a surgical fixing screw comprising a head and an externally screw-threaded shank which is divided longitudinally into lateral wings which are capable of being deformed outwardly of the longitudinal axis of the shank. This obviates or mitigates the risk of the screw becoming detached from, or loosened in, a hole in bone or hard tissue in which the screw shank is engaged in use.
Conveniently, the shank is adapted to receive an expansion means which, during insertion into the fixing screw, causes the outward deformation of the wings. Desirably, the body of the shank tapers inwardly away from the head.
Preferably, the expansion means is held within the shank by means of a complementary thread arrangement.
Most preferably, the expansion means for causing outward deformation of the wings and the retaining means for the head are provided as different parts of a single retaining and expansion element engageable with the shank and the head of the screw.
Preferably, the surgical fixing screw is constructed and adapted for use in the securing of a surgical implant in position. The head of the screw may have a first formation for engagement, in use, by a screwdriver and a second formation, spatially distinct from the first formation, for engagement, in use, by an alternative screwdriver. Thus, in the event that one of the first and second formations becomes damaged during insertion or removal of the screw using the appropriate screwdriver, the screw can be removed subsequently using the other screwdriver on the other of the first and second formations.
Desirably, said first and second formations are spaced apart longitudinally in the axis of rotation of the surgical fixing screw.
Embodiments of the present invention will now be described, by way of example, with reference to the accompanying drawings in which:-
Fig 1 is a perspective view of a surgical implant in accordance with said first aspect of the present invention;
Fig 2 is a plan view of the surgical implant shown in Fig 1 ;
Fig 3 is an end-on view of the surgical implant shown in Fig 1 ;
Fig 4 is a cross-sectional view of the surgical implant shown in Fig 1 ;
Fig 5 is a schematic illustration showing the attachment of two surgical implants according to the present invention to a single cervical vertebra;
Fig 6 is a side view of an example of a surgical fixing screw according to said second aspect of the present invention;
Fig 7 is a axial section through the surgical fixing screw of Fig 6;
Fig 8 is a perspective view of the surgical fixing screw of Figs 6 and 7;
Fig 9 is an end view of the head of the surgical fixing screw of Figs 6 to 8;
Fig 10 is a side view of an expansion element for use in the fixing screw of
Figs 6 to 9;
Fig 1 1 is a plan view similar to Fig 2 of another embodiment of surgical implant; Fig 12 is a side view of the implant of Fig 11 ;
Fig 13 is an axial section through an embodiment of surgical fixing screw for use with the implant of Figs 1 1 and 12;
Fig 14 is a perspective view of the surgical fixing screw of Fig 13;
Fig 15 is an axial section showing the surgical fixing screw of Figs 13 and
14 with an inserted retaining and expansion element;
Fig 16 is a detail showing the interengagement between the screw of Fig
15 and the implant of Figs 1 1 and 12; and
Fig 1 7 is a view showing the use of the implant of Figs 1 1 and 12 and surgical fixing screws of Figs 13 to 15 to secure two cervical vertebrae together.
Referring to Figs 1 and 2, the surgical implant 2 is U-shaped and comprises a curved flange-like body portion 4 having a posterior major surface 6a, an anterior major surface 6b, a superior edge surface 8a and an inferior edge surface 8b, and a pair of mutually spaced, parallel straight arms 10. The implant 2 is of unitary construction and, in this embodiment, is made from titanium alloy (complying with BS7252 PT3 1990). At each opposite lateral end region of the body portion 4, a respective one of the arm 10 extends away from the body portion 4. The depth of the arms 10 (i.e. the distance between their upper surfaces 12a and lower surfaces 12b) is less than that of the body portion 4, such that upper end abutment surfaces 14a and lower end abutment surfaces 14b are defined on the body portion 4. The superior and inferior surfaces 12a,12b of each arm 10 are roughened and provided with a hydroxy- apatite coating (not shown). The body portion 4 is provided with two pairs of identical passages 16a and 16b which extend through the body portion 4 from the posterior major surface 6a to the anterior major surface 6b of the body portion 4. Referring to Figs 3 and 4, the passages 16a are spaced apart along the body portion 4 at a distance from the superior edge surface 8a of the body portion 4, while the passages 16b are at the same distance from the inferior edge surface 8b of the body portion 4 and offset relative to the first passages 16a. Each passage 16a, 16b comprises anterior and posterior coaxial cylindrical regions 18a,18b of different diameters such that an annular step 20, which serves as a seat for a fixing screw, is defined at their intersection. The axis of each of the passages 16a is inclined above the direction of extent of the arms 10 by 10°. The axis of each of the passages 16b is inclined below the direction of extent of the arms 10 by 10°.
The surgical implant 2 may be used in an operation where, for whatever reason, it is necessary to replace the intervertebral disc between a pair of adjacent cervical vertebrae by a bone graft. In such an operation, the disc (or fragments thereof) is removed and the inferior surface of a first (superior) disc and the superior surface of an adjacent second (inferior) disc are prepared for the reception of a bone graft. Bone graft material is compacted between the vertebrae and the arms 10 of the implant 2 are pushed between the vertebrae, either side of the bone graft material, from the anterior side of the vertebrae. The respective regions of the posterior major surface 6a abut the anterior surfaces of the first and second vertebra.
The fact that the arms 10 of the implant 2 are located between the vertebrae ensures that there is no error in the alignment of the implant 2 before it is fixed in place. Such fixing is achieved by forming holes in the vertebrae using the passages 16 in the body portion 4 as guides, followed by inserting expanding surgical fixing screws, for example surgical fixing screws 100 as described below, through each passage 16a,16b in the body portion 4 and into the respective vertebra. In cases where two or more consecutive discs must be removed, it is possible to repeat the above procedure relative to one of the first and second vertebrae and a superior or inferior adjacent third vertebra using a second implant, and so on. It should be noted that the offset positioning of the passages 16a, 16b ensures that the screws used to fix the respective first and second implants do not interfere with each other. This is illustrated in Fig 5, where it can be seen that the design of the implant is such that two identical implants 2a and 2b can be secured to a single vertebra V using the two intermediate pairs of screws 100 which are mutually offset because of the positioning of the passages 16a,16b. It will be understood that the vertebrae (not shown in Fig 5) which are adjacent to the illustrated vertebra V will be respectively secured by upper and lower pairs of screws 100 illustrated in Fig. 5.
Each surgical fixing screw 100 is tightened until the head of the screw is seated against the annular step 20, at which point the vertebrae are securely fixed relative to each other. The fixing in place of the implant 2 is enhanced by the inclination of the passages 16 in the body portion 4, which makes it more difficult for the implant 2 to work loose than if the passages 16a, 16b were mutually parallel or parallel to the direction of extent of the arms 10. The expanding nature of the screws 100 also assists in ensuring a secure fixing of the implant in place. Once in place, the roughened and hydroxy-apatite coated superior and inferior surfaces 12a, 12b encourage in-growth of bone on those surfaces 12a, 12b of the arms 10 only.
In the above-described procedure, it is generally intended for the implant 2 to remain permanently in place, however, there may be circumstances in which it is necessary for it to be removed. Should this be necessary, the implant 2 can be withdrawn by unscrewing the screws 100 and withdrawing the implant. Clearly, any bonding between the upper and lower surfaces 12a, 12b of the arms with the vertebrae must be broken, but the bone graft between the arms 10 will remain intact. Thus, replacement or permanent removal of the implant 2 can be achieved without requiring a second bone graft.
Referring now to Figs. 6 to 9, the surgical fixing screw 100 comprises two parts, a shank 101 and a head 102. The shank 101 has an exterior screw thread 103 such that the body of the shank 101 decreases in diameter away from the head 102. The flight 104 of the screw thread 103 is, however, of constant diameter over the region AB, decreasing in diameter in only the terminal turn adjacent A. The flight 104 has a flat crest which increases in width towards the head 102 over the region AB. A passage 105 extends longitudinally throughout the length of the fixing screw 100. Two diametrically opposed slots 106 extend radially inwardly from the peripheral surface of the shank 101 to communicate with the passage 105. The slots 106 and passage 105 extend over the length of the shank 101 so as to divide the latter longitudinally into two lateral wings 107.
The passage 105 comprises three parts, a tapered end region 108, an intermediate screw-threaded region 109 and a head end region 120. The head end region 120 defines an internal recessed hexagonal formation 121 which opens onto the head end of the screw 100 and which , in use, engagingly receives a screwdriver having a hexagonal bit (not shown).
A step 122 is defined at the junction between the regions 109 and 120 which are situated within the head 102 of the screw 100. The step 122 faces the head end of the screw and has a cross-recessed formation 123 therein which, in use, engagingly receives another screwdriver having a cross-headed bit (not shown). It will therefore be understood that the formations 121 and 123 are spatially distinct (in this embodiment, they are spaced apart along the longitudinal axis of the screw) and are independently engageable by the respective screwdrivers.
The screw-threaded region 109 is adapted to receive an expansion element 124 (Fig 10) which will be described later.
The tapered end region 108 of the passage 105 tapers inwardly away from the intermediate screw-threaded region 109 and extends over the whole of the length of the shank 101.
The head 102 has an outer peripheral surface 126 provided with a radial lip 127 so as to form an abutment shoulder 128 for engagement, in use, against the step 20 described above.
Referring now to Fig 10, the expansion element 124 comprises a head region 130, an intermediate externally screw-threaded region 131 and a rod-like region 132. The head region 130 has a slot 133 for cooperative engagement by a further screwdriver bit. The intermediate screw-threaded region 131 is engageable with the internal screw-threaded region 109 such that the expansion element 124 can be fixed within the passage 105. The rod-like region 132 projects from the threaded region 131 and has a diameter larger than the minimum diameter of the tapered region 108.
In order to effect engagement of the fixing screw 100 in bone, a borehole is drilled in the latter and the screw 100 is secured in the borehole by rotating it using the hexagonal or cross-recessed formations 121 or 123 with the appropriate screwdriver. Then, the expansion element 124 is inserted into the screw 100 and is rotated using the further screwdriver bit engaged in the slot 133.
When the expansion element 124 is fully engaged within the passage 105, the action of the rod-like region 132 upon the internal surfaces of the tapered region 108 of the passage 105 deforms the lateral wings 107 outwardly, thus locking the screw 100 in the borehole and inhibiting backing out or loosening of the fixing screw 100.
If necessary, the fixing screw 100 can be extracted from the bone, after removal of the expansion element 124, by use of a suitable screw driver engaged with either of the formations 121 , 123. This allows the option of choosing one specific formation 121 or 123 should the alternative formation 123 or 121 become damaged or otherwise unserviceable. This choice is especially advantageous as the lateral wings 107 will remain deformed after the removal of the expansion member 124 and therefore an effective engagement of the screwdriver with the chosen formation is essential.
The above described surgical fixing screw 100 may be used for other surgical applications.
Referring now to Figs 1 1 and 12, the surgical implant 2 is, like that of Figs 1 to 5, for fusing adjacent cervical vertebrae together, and similar parts are accorded the same reference numerals. In this embodiment, however, the arms 10 are not disposed at opposite lateral ends of curved flange-like body portion 4 but are spaced slightly inwardly of the ends. Also, as can be seen from Fig 12, the superior and inferior surfaces of the arms 10 are not mutually parallel but are mutually tapered. This tapering is chosen so as to restore and/or maintain cervical lordosis (natural curvature of the spine). The lateral surfaces of the arms 10 are, however, mutually parallel as in the case of the embodiment of Figs 1 to 4.
A variety of implants 2 of different size may be provided with the arms 10 available in varying heights and widths to fit different anatomies.
Notches 17 are provided in the ends (lateral faces) of the body portion 4 and on the free ends (posterior faces) of the arms 10. These notches 17 enable the surgeon to tie a suture around the implant in order to hold the bone graft in position during insertion.
As can best be seen from Fig 17, the superior and inferior faces of the body portion 4 are formed with complementary recesses and lugs to enable adjacent implants to be stacked closely together. In this embodiment, the implant 2 has two superior apertures 16a and one inferior aperture 16b.
Referring now to Figs 13 to 15, surgical fixing screw 100 is similar to that of Figs 6 to 10 and similar parts are accorded the same reference numerals. In this embodiment, however, head 102 has a series of four equi-angularly spaced slots 140 extending from the outside of the head 102 to open into the head end region 120 of the passage 105. These slots 140 permit the head to be transformed between a laterally relatively expanded condition as illustrated in Figs 14, 15 and 16 and a laterally relatively contracted condition (not shown). These slots 140 also enable a screwdriver with a cross-headed bit to be engaged with the head 102 of the screw 100. Internal recessed hexagonal formation 121 , in this embodiment, is disposed within the region of the shank 101 adjacent the head 102 rather than within the latter. In this embodiment, the passage 105 does not extend over the full length of the shank 101 but terminates at a conical end wall spaced from the free end of the shank. The slots 106 extend over part of the length portion 108 of the passage 105 to the free end of the shank 101. Also, the portion 108 of the passage 105 is not tapered but is parallel sided.
The head region 130 of the expansion element 124 comprises an inwardly tapering frusto-conical head portion 130a and a cylindrical head portion 130b. The frustum of the head portion 130a has a larger diameter than the adjacent head portion 130b so that a step 130c is defined between these two portions. The head portion 130b is of a size such that it is rotatable with clearance within the hexagonal formation 121. The base of the frusto-conical head portion 130a is equal in diameter to that of the head end region 120 of the passage 105 when the head is in its laterally expanded condition.
Referring now to Fig 16, the surgical fixing screw 100 described above in relation to Figs 13 to 15 is mainly intended to be used with the surgical implant described above in relation to Figs 1 1 and 12. However, it does have other potential surgical uses. The anterior region 18a of each passage 16a or 16b has a diameter which is slightly less than that of the radial lip 127. Adjacent to the anterior region 18a of the passage 16, there is an undercut annular recess 150 following which the posterior region 18b of the passage 16 is provided. The posterior region 18b has a diameter which is marginally greater than the outer diameter of the head 102 of the screw 100.
In order to secure the implant 2 in position, a hole is drilled into the respective cervical vertebra through each aperture 16a, 16b. Then, each fixing screw 100 is inserted through the respective aperture 16a or 16b and rotated to cause it to advance into the hole in the cervical vertebra until the lip 127 engages against the body portion 4 around the anterior end of the passage 16. Because the lip 127 is curved, the head 102 is deformed radially inwardly into its laterally contracted condition as permitted by the partial closure of the slots 140. This allows the lip 127 to pass through the anterior region 18a and into the recess 150. When it reaches the recess 150, the head 102 is free to spring outwardly so that the lip 127 extends into the recess 150, thereby providing an interlock to prevent unwanted disengagement of the lip 127 from the undercut recess 150. The screw 100 can then be fully tightened to urge the implant against the cervical vertebrae. Then, the expansion element 124 is inserted into the screw 100 and rotated so as to cause the wings of the screw to be expanded outwardly to anchor the screw within the hole drilled in the cervical vertebra. At the same time, the head region 130 of the expansion element 124 enters the recess 120 fully and serves to retain the head 102 against being compressed radially inwardly. The head portion 130a may also serve to urge the head portion 102 outwardly if any permanent deformation of the head of the screw has taken place as a result of the lip 127 being forced through the smaller diameter anterior region 18a of the passage 16. In this way, the screw 100 is securely interlocked with the body portion 4 of the surgical implant 2.
Fig 17 shows the arrangement where three screws 100 are used to secure the surgical implant 2 in position, with two of the screws being engaged with the upper cervical vertebra V and one screw being engaged with the lower cervical vertebra V of the pair to be fused together. The superior and inferior faces of the body portion 4 of the implant 2 are suitably shaped with a lug and recess arrangement to enable each portion 4 to be nested closely with the body portion(s) 4 of adjacent implant(s) 2.

Claims

1. A surgical implant comprising:-
(i) a body portion (4) having first and second passages (16a, 16b) therethrough, each of said passages (16) being adapted and disposed in said body portion (4) so as to be capable of receiving a securing element (100) for securing said implant to first and second adjacent vertebrae respectively; and
(ii) first and second mutually spaced arms (10) carried by and extending away from said body portion (4); wherein said arms (10) are adapted so as to be capable of insertion between said first and second adjacent vertebrae (V), and wherein at least part of said body portion (4) is adapted to engage with anterior faces of both adjacent vertebrae (V) when said arms (10) are located between said adjacent vertebrae, so that, in use, a bone graft can be held in position between the first and second arms (10) and between mutually facing superior and inferior surfaces of said first and second adjacent vertebrae (V).
2. A surgical implant as claimed in Claim 1 , wherein the body portion (4) is constructed such that, when the arms (10) are located between said first and second adjacent vertebrae (V), another implant can be secured to the anterior face of one of the first and second adjacent vertebrae and a third vertebra, said third vertebra being adjacent to the same one of said first or second adjacent vertebrae.
3. A surgical implant as claimed in Claim 1 or 2, wherein the arms (10) are straight and mutually parallel.
4. A surgical implant as claimed in Claim 1 , 2 or 3, wherein the body portion (4) is provided with more than two passages (16a, 16b).
5. A surgical implant as claimed in any preceding claim, wherein at least one passage (16a, 16b) has its axis inclined to the arms (10).
6. A surgical implant as claimed in any preceding claim, wherein at least said first and said second passages (16a, 16b) have mutually inclined axes.
7. A surgical implant as claimed in any preceding claim, wherein at least one of said passages (16a, 16b) has an undercut recess (150) therein.
8. A system for fusing adjacent vertebrae comprising at least one surgical implant as claimed in any preceding claim, at least one bone graft, and securing elements (100) for securing the implant to adjacent vertebrae.
9. A method of fusing adjacent vertebrae (V) comprising the steps of:-
(i) introducing bone graft material between first and second adjacent vertebrae (V),
(ii) locating the arms (10) of a surgical implant (2) as claimed in any one of Claims 1 to 7 around said bone graft material and between said adjacent vertebrae (V),
(iii) securing at least one securing element (100) into the first vertebra
(V), and
(iv) securing at least one securing element (100) into the second vertebra (V), wherein each securing element (100) passes through a respective one of said passages (16a, 16b) in the body portion (4) of the implant (2).
10. A surgical fixing screw including a head (102) and an externally screw-threaded shank (101 ), wherein the head (102) is formed so that it can be transformed between a laterally relatively expanded condition and a laterally relatively contracted condition.
1 1 . A surgical fixing screw as claimed in Claim 10, further including retaining means (130) engageable with the head (102) for preventing the head (102) from being transformed into its laterally contracted condition.
12. A surgical fixing screw as claimed in Claim 10 or 1 1 , wherein the head (102) has a portion (127) which, when the head is in its laterally expanded condition, is adapted to engage in an undercut recess (150) in a passage (16a, 16b) in a part (2) to be secured by the fixing screw.
13. A surgical fixing screw comprising a head (102) and an externally screw-threaded shank (101) which is divided longitudinally into lateral wings (107) which are capable of being deformed outwardly of the longitudinal axis of the shank (101).
14. A surgical fixing screw as claimed in Claim 13, wherein the shank (101 ) is adapted to receive an expansion means (132) which, during insertion into the fixing screw, causes the outward deformation of the wings (107).
15. A surgical fixing screw as claimed in Claim 14, wherein the expansion means (132) is adapted to be held within the shank (101) by means of a complementary thread arrangement (109, 131).
16. A surgical fixing screw as claimed in any one of Claims 10 to 15, wherein the head (102) has a first formation (121 , 140) for engagement, in use, by a screwdriver, and a second formation (123, 121), spatially distinct from the first formation (121 , 140), for engagement, in use, by an alternative screwdriver.
17. A surgical fixing screw as claimed in Claim 16, wherein said first and second formations (121 , 140 and 123, 121) are spaced apart longitudinally in the axis of rotation of the fixing screw.
18. A surgical fixing screw as claimed in any one of claims 10 to 17, wherein the shank (101) has a body which tapers inwardly away from the head (102) and external screw-threading (103) on the shank (101) has a flight (103) of constant diameter over part of the tapered body of the shank.
19. A surgical fixing screw as claimed in claim 18, wherein the flight (103) has a flat crest (104) which increases in width towards the head (102) over a region of the screw threading (103).
20. A surgical fixing screw including a head (102) and an externally screw-threaded shank (101 ), wherein the head (102) is formed so that it can be transformed between a laterally relatively expanded condition and a laterally relatively contracted condition, and wherein the externally screw-threaded shank (101) is divided longitudinally into lateral wings (107) which are capable of being deformed outwardly of the longitudinal axis of the shank (101 ).
21. A surgical fixing screw as claimed in Claim 10, further including retaining means (130) engageable with the head (102) for preventing the head (102) from being transformed into its laterally contracted condition, and wherein the shank (101) is adapted to receive an expansion means (132) which, during insertion into shank (101), causes the outward deformation of the wings (107).
22. A surgical fixing screw as claimed in claim 21 , wherein the retaining means (130) and the expansion means (132) are provided as different parts of a single retaining and expansion element (124) engageable with the shank (101 ) and the head (102).
EP98955808A 1997-11-29 1998-11-27 Surgical implant and surgical fixing screw Expired - Lifetime EP1033941B1 (en)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
GBGB9725259.7A GB9725259D0 (en) 1997-11-29 1997-11-29 Surgical implant
GB9725258 1997-11-29
GBGB9725258.9A GB9725258D0 (en) 1997-11-29 1997-11-29 Fixing screw
GB9725259 1997-11-29
PCT/GB1998/003557 WO1999027864A2 (en) 1997-11-29 1998-11-27 Surgical implant and surgical fixing screw

Publications (2)

Publication Number Publication Date
EP1033941A2 true EP1033941A2 (en) 2000-09-13
EP1033941B1 EP1033941B1 (en) 2004-08-04

Family

ID=26312682

Family Applications (1)

Application Number Title Priority Date Filing Date
EP98955808A Expired - Lifetime EP1033941B1 (en) 1997-11-29 1998-11-27 Surgical implant and surgical fixing screw

Country Status (9)

Country Link
US (1) US6579290B1 (en)
EP (1) EP1033941B1 (en)
JP (1) JP2001524346A (en)
KR (1) KR20010032576A (en)
AT (1) ATE272363T1 (en)
AU (1) AU748062B2 (en)
DE (1) DE69825472T2 (en)
ES (1) ES2226186T3 (en)
WO (1) WO1999027864A2 (en)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9744049B2 (en) 2007-11-16 2017-08-29 DePuy Synthes Products, Inc. Low profile intervertebral implant
US9848992B2 (en) 2010-12-21 2017-12-26 DePuy Synthes Products, Inc. Intervertebral implants, systems, and methods of use
US9867718B2 (en) 2014-10-22 2018-01-16 DePuy Synthes Products, Inc. Intervertebral implants, systems, and methods of use
US10064740B2 (en) 2003-02-06 2018-09-04 DePuy Synthes Products, LLC Intervertebral implant
US10433976B2 (en) 2008-11-07 2019-10-08 DePuy Synthes Products, Inc. Zero-profile interbody spacer and coupled plate assembly

Families Citing this family (167)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6695848B2 (en) 1994-09-02 2004-02-24 Hudson Surgical Design, Inc. Methods for femoral and tibial resection
US8603095B2 (en) 1994-09-02 2013-12-10 Puget Bio Ventures LLC Apparatuses for femoral and tibial resection
FR2753368B1 (en) * 1996-09-13 1999-01-08 Chauvin Jean Luc EXPANSIONAL OSTEOSYNTHESIS CAGE
US6461359B1 (en) 1999-11-10 2002-10-08 Clifford Tribus Spine stabilization device
FR2803741B1 (en) * 2000-01-13 2003-04-11 Jean Claude Bouvet INTERSOMATIC CAGE
US6673113B2 (en) 2001-10-18 2004-01-06 Spinecore, Inc. Intervertebral spacer device having arch shaped spring elements
US7169182B2 (en) 2001-07-16 2007-01-30 Spinecore, Inc. Implanting an artificial intervertebral disc
US8062377B2 (en) 2001-03-05 2011-11-22 Hudson Surgical Design, Inc. Methods and apparatus for knee arthroplasty
BR8100696U (en) * 2001-04-10 2002-03-19 Aziz Rassi Neto Constructive arrangement introduced in surgical screw
US7713302B2 (en) 2001-10-01 2010-05-11 Spinecore, Inc. Intervertebral spacer device utilizing a spirally slotted belleville washer having radially spaced concentric grooves
US7771477B2 (en) 2001-10-01 2010-08-10 Spinecore, Inc. Intervertebral spacer device utilizing a belleville washer having radially spaced concentric grooves
GB2381197A (en) * 2001-10-25 2003-04-30 Corin Surgical Ltd A surgical implant
US7070599B2 (en) 2002-07-24 2006-07-04 Paul Kamaljit S Bone support assembly
US6755833B1 (en) 2001-12-14 2004-06-29 Kamaljit S. Paul Bone support assembly
US7077864B2 (en) * 2002-02-12 2006-07-18 Cross Medical Products, Inc. Vertebral interbody cage with translatable locking screw
AR038680A1 (en) 2002-02-19 2005-01-26 Synthes Ag INTERVERTEBRAL IMPLANT
US8038713B2 (en) 2002-04-23 2011-10-18 Spinecore, Inc. Two-component artificial disc replacements
US20080027548A9 (en) 2002-04-12 2008-01-31 Ferree Bret A Spacerless artificial disc replacements
US6706068B2 (en) 2002-04-23 2004-03-16 Bret A. Ferree Artificial disc replacements with natural kinematics
US6899735B2 (en) * 2002-10-02 2005-05-31 Sdgi Holdings, Inc. Modular intervertebral prosthesis system
US7320708B1 (en) 2002-11-13 2008-01-22 Sdgi Holdings, Inc. Cervical interbody device
WO2004071276A2 (en) 2003-02-05 2004-08-26 Pioneer Laboratories, Inc. Bone plate system
AU2004220634B2 (en) * 2003-03-06 2009-09-17 Spinecore, Inc. Instrumentation and methods for use in implanting a cervical disc replacement device
US6908484B2 (en) 2003-03-06 2005-06-21 Spinecore, Inc. Cervical disc replacement
US7819903B2 (en) 2003-03-31 2010-10-26 Depuy Spine, Inc. Spinal fixation plate
US9278009B2 (en) * 2003-04-21 2016-03-08 Rsb Spine Llc Spine implants
US7985255B2 (en) 2003-04-21 2011-07-26 Rsb Spine Llc Implant subsidence control
US20170020683A1 (en) 2003-04-21 2017-01-26 Rsb Spine Llc Bone plate stabilization system and method for its use
US8100976B2 (en) 2003-04-21 2012-01-24 Rsb Spine Llc Implant subsidence control
US8613772B2 (en) 2003-04-21 2013-12-24 Rsb Spine Llc Lateral mount implant device
US6984234B2 (en) * 2003-04-21 2006-01-10 Rsb Spine Llc Bone plate stabilization system and method for its use
EP1501453B2 (en) 2003-05-14 2010-06-30 Kilian Kraus Height-adjustable implant to be inserted between vertebral bodies and corresponding handling tool
US20050049595A1 (en) 2003-09-03 2005-03-03 Suh Sean S. Track-plate carriage system
US7909860B2 (en) 2003-09-03 2011-03-22 Synthes Usa, Llc Bone plate with captive clips
US7235105B2 (en) * 2003-09-18 2007-06-26 Jackson Roger P Threaded center line cage with winged end gap
US20050065605A1 (en) * 2003-09-18 2005-03-24 Jackson Roger P. Threaded center line cage with funnel shaped profile
MXPA06004374A (en) * 2003-10-20 2006-07-06 Blackstone Medical Inc Vertebral body replacement apparatus and method.
DE20320974U1 (en) * 2003-12-11 2005-08-25 Deltacor Gmbh Surgical backbone implant is positioned between adjacent vertebrae and consists of two concentric cylinders with interlocking fingers in cruciform array, where the cylinder inner faces bear a thread
US7815645B2 (en) 2004-01-14 2010-10-19 Hudson Surgical Design, Inc. Methods and apparatus for pinplasty bone resection
US7857814B2 (en) 2004-01-14 2010-12-28 Hudson Surgical Design, Inc. Methods and apparatus for minimally invasive arthroplasty
US20060030854A1 (en) 2004-02-02 2006-02-09 Haines Timothy G Methods and apparatus for wireplasty bone resection
US8114083B2 (en) 2004-01-14 2012-02-14 Hudson Surgical Design, Inc. Methods and apparatus for improved drilling and milling tools for resection
US8021368B2 (en) 2004-01-14 2011-09-20 Hudson Surgical Design, Inc. Methods and apparatus for improved cutting tools for resection
US9814539B2 (en) * 2004-01-14 2017-11-14 Puget Bioventures Llc Methods and apparatus for conformable prosthetic implants
US7740649B2 (en) 2004-02-26 2010-06-22 Pioneer Surgical Technology, Inc. Bone plate system and methods
US8900277B2 (en) 2004-02-26 2014-12-02 Pioneer Surgical Technology, Inc. Bone plate system
US7691133B2 (en) * 2004-11-30 2010-04-06 Integra Lifesciences Corporation Systems and methods for bone fixation
WO2006069089A2 (en) * 2004-12-21 2006-06-29 Packaging Service Corporation Of Kentucky Cervical plate system
US8496708B2 (en) * 2005-03-17 2013-07-30 Spinal Elements, Inc. Flanged interbody fusion device with hinge
US20070067034A1 (en) * 2005-08-31 2007-03-22 Chirico Paul E Implantable devices and methods for treating micro-architecture deterioration of bone tissue
US8998923B2 (en) * 2005-08-31 2015-04-07 Spinealign Medical, Inc. Threaded bone filling material plunger
US7887595B1 (en) 2005-12-05 2011-02-15 Nuvasive, Inc. Methods and apparatus for spinal fusion
EP1988855A2 (en) 2006-02-27 2008-11-12 Synthes GmbH Intervertebral implant with fixation geometry
US20080058808A1 (en) 2006-06-14 2008-03-06 Spartek Medical, Inc. Implant system and method to treat degenerative disorders of the spine
US20080051900A1 (en) * 2006-07-28 2008-02-28 Spinalmotion, Inc. Spinal Prosthesis with Offset Anchors
US8114162B1 (en) 2006-08-09 2012-02-14 Nuvasive, Inc. Spinal fusion implant and related methods
USD708747S1 (en) 2006-09-25 2014-07-08 Nuvasive, Inc. Spinal fusion implant
WO2008067022A2 (en) * 2006-10-02 2008-06-05 The Cleveland Clinic Foundation Fastener assembly
US8449583B2 (en) 2006-10-02 2013-05-28 The Cleveland Clinic Foundation Fastener assembly
US9039768B2 (en) 2006-12-22 2015-05-26 Medos International Sarl Composite vertebral spacers and instrument
WO2008109566A1 (en) * 2007-03-02 2008-09-12 Spinealign Medical, Inc. Fracture fixation system and method
WO2008109870A1 (en) * 2007-03-07 2008-09-12 Spinealign Medical, Inc. Transdiscal interbody fusion device and method
WO2008109872A2 (en) * 2007-03-07 2008-09-12 Spinealign Medical, Inc. Systems, methods, and devices for soft tissue attachment to bone
US20080249569A1 (en) * 2007-04-03 2008-10-09 Warsaw Orthopedic, Inc. Implant Face Plates
US8425607B2 (en) * 2007-04-03 2013-04-23 Warsaw Orthopedic, Inc. Anchor member locking features
US8268000B2 (en) * 2007-04-03 2012-09-18 Warsaw Orthopedic, Inc. Composite interbody spacer
US8211148B2 (en) * 2007-04-24 2012-07-03 Warsaw Orthopedic Prostheses for locking an artificial disc in an intervertebral disc space
US20090276048A1 (en) * 2007-05-08 2009-11-05 Chirico Paul E Devices and method for bilateral support of a compression-fractured vertebral body
WO2008137192A1 (en) * 2007-05-08 2008-11-13 Spinealign Medical, Inc. Systems, devices and methods for stabilizing bone
FR2916343B1 (en) * 2007-05-23 2010-02-26 Charles Khalife INTER SOMATIC MOBILE DEVICE
US8083772B2 (en) 2007-06-05 2011-12-27 Spartek Medical, Inc. Dynamic spinal rod assembly and method for dynamic stabilization of the spine
WO2008151096A1 (en) 2007-06-05 2008-12-11 Spartek Medical, Inc. A deflection rod system for a dynamic stabilization and motion preservation spinal implantation system and method
US8114134B2 (en) 2007-06-05 2012-02-14 Spartek Medical, Inc. Spinal prosthesis having a three bar linkage for motion preservation and dynamic stabilization of the spine
US8298267B2 (en) 2007-06-05 2012-10-30 Spartek Medical, Inc. Spine implant with a deflection rod system including a deflection limiting shield associated with a bone screw and method
US8177815B2 (en) 2007-06-05 2012-05-15 Spartek Medical, Inc. Super-elastic deflection rod for a dynamic stabilization and motion preservation spinal implantation system and method
US7963978B2 (en) 2007-06-05 2011-06-21 Spartek Medical, Inc. Method for implanting a deflection rod system and customizing the deflection rod system for a particular patient need for dynamic stabilization and motion preservation spinal implantation system
US8048115B2 (en) 2007-06-05 2011-11-01 Spartek Medical, Inc. Surgical tool and method for implantation of a dynamic bone anchor
US8021396B2 (en) 2007-06-05 2011-09-20 Spartek Medical, Inc. Configurable dynamic spinal rod and method for dynamic stabilization of the spine
US8092501B2 (en) 2007-06-05 2012-01-10 Spartek Medical, Inc. Dynamic spinal rod and method for dynamic stabilization of the spine
US8273127B2 (en) 2007-06-06 2012-09-25 Spinesmith Partners, L.P. Interbody fusion device and associated methods
US8361126B2 (en) 2007-07-03 2013-01-29 Pioneer Surgical Technology, Inc. Bone plate system
US8623019B2 (en) 2007-07-03 2014-01-07 Pioneer Surgical Technology, Inc. Bone plate system
US7867263B2 (en) * 2007-08-07 2011-01-11 Transcorp, Inc. Implantable bone plate system and related method for spinal repair
US8709054B2 (en) * 2007-08-07 2014-04-29 Transcorp, Inc. Implantable vertebral frame systems and related methods for spinal repair
WO2009021144A2 (en) * 2007-08-07 2009-02-12 Transcorp, Inc. Device for variably adjusting intervertebral distraction and lordosis
US8430882B2 (en) * 2007-09-13 2013-04-30 Transcorp, Inc. Transcorporeal spinal decompression and repair systems and related methods
US8323320B2 (en) * 2007-09-13 2012-12-04 Transcorp, Inc. Transcorporeal spinal decompression and repair system and related method
WO2009036360A1 (en) * 2007-09-13 2009-03-19 Transcorp, Inc. Device and method for tissue retraction in spinal surgery
US8852280B2 (en) * 2007-09-27 2014-10-07 Warsaw Orthopedic, Inc. Intervertebral implant
WO2009070607A1 (en) * 2007-11-27 2009-06-04 Transcorp, Inc. Methods and systems for repairing an intervertebral disc using a transcorporal approach
US20090216260A1 (en) * 2008-02-20 2009-08-27 Souza Alison M Interlocking handle
US8267979B2 (en) 2008-02-26 2012-09-18 Spartek Medical, Inc. Load-sharing bone anchor having a deflectable post and axial spring and method for dynamic stabilization of the spine
US8333792B2 (en) 2008-02-26 2012-12-18 Spartek Medical, Inc. Load-sharing bone anchor having a deflectable post and method for dynamic stabilization of the spine
US8007518B2 (en) 2008-02-26 2011-08-30 Spartek Medical, Inc. Load-sharing component having a deflectable post and method for dynamic stabilization of the spine
US8337536B2 (en) 2008-02-26 2012-12-25 Spartek Medical, Inc. Load-sharing bone anchor having a deflectable post with a compliant ring and method for stabilization of the spine
US8083775B2 (en) 2008-02-26 2011-12-27 Spartek Medical, Inc. Load-sharing bone anchor having a natural center of rotation and method for dynamic stabilization of the spine
US8016861B2 (en) 2008-02-26 2011-09-13 Spartek Medical, Inc. Versatile polyaxial connector assembly and method for dynamic stabilization of the spine
US8097024B2 (en) 2008-02-26 2012-01-17 Spartek Medical, Inc. Load-sharing bone anchor having a deflectable post and method for stabilization of the spine
US8211155B2 (en) 2008-02-26 2012-07-03 Spartek Medical, Inc. Load-sharing bone anchor having a durable compliant member and method for dynamic stabilization of the spine
US8057515B2 (en) 2008-02-26 2011-11-15 Spartek Medical, Inc. Load-sharing anchor having a deflectable post and centering spring and method for dynamic stabilization of the spine
US20090248092A1 (en) 2008-03-26 2009-10-01 Jonathan Bellas Posterior Intervertebral Disc Inserter and Expansion Techniques
US8480716B2 (en) 2008-04-25 2013-07-09 Pioneer Surgical Technology, Inc. Bone plate system
WO2010009287A2 (en) * 2008-07-16 2010-01-21 Spinealign Medical, Inc. Morselizer
US8623062B2 (en) * 2008-09-29 2014-01-07 Dimitriy G. Kondrashov System and method to stablize a spinal column including a spinolaminar locking plate
KR100898957B1 (en) * 2008-10-02 2009-05-25 (주) 코리아나메디칼 Stem for using artificial leg coupling
US10045860B2 (en) * 2008-12-19 2018-08-14 Amicus Design Group, Llc Interbody vertebral prosthetic device with self-deploying screws
WO2010078488A2 (en) * 2008-12-31 2010-07-08 Spinealign Medical, Inc. Self-expanding bone stabilization devices
US8968405B2 (en) * 2009-01-20 2015-03-03 Incite Innovation Llc Interbody fusion device and method of operation
WO2010093658A2 (en) * 2009-02-10 2010-08-19 Synthes Usa, Llc Screw with variable diameter cannulation and driver
US9220547B2 (en) * 2009-03-27 2015-12-29 Spinal Elements, Inc. Flanged interbody fusion device
US9526620B2 (en) 2009-03-30 2016-12-27 DePuy Synthes Products, Inc. Zero profile spinal fusion cage
US9095444B2 (en) 2009-07-24 2015-08-04 Warsaw Orthopedic, Inc. Implant with an interference fit fastener
US9730804B2 (en) 2009-09-06 2017-08-15 Warsaw Orthopedic, Inc. Locking spinal fusion device
US8906028B2 (en) 2009-09-18 2014-12-09 Spinal Surgical Strategies, Llc Bone graft delivery device and method of using the same
US10973656B2 (en) 2009-09-18 2021-04-13 Spinal Surgical Strategies, Inc. Bone graft delivery system and method for using same
US10245159B1 (en) 2009-09-18 2019-04-02 Spinal Surgical Strategies, Llc Bone graft delivery system and method for using same
US8740983B1 (en) * 2009-11-11 2014-06-03 Nuvasive, Inc. Spinal fusion implants and related methods
US8840668B1 (en) 2009-11-11 2014-09-23 Nuvasive, Inc. Spinal implants, instruments and related methods
EP2506785A4 (en) 2009-12-02 2014-10-15 Spartek Medical Inc Low profile spinal prosthesis incorporating a bone anchor having a deflectable post and a compound spinal rod
US9393129B2 (en) 2009-12-10 2016-07-19 DePuy Synthes Products, Inc. Bellows-like expandable interbody fusion cage
US8657859B2 (en) 2009-12-16 2014-02-25 Advanced Veterinary Solutions Implant for promoting stability of the canine stifle joint
US8758416B2 (en) * 2010-03-10 2014-06-24 Paul J. Pagano Odontoid fracture dynamic compression apparatus and method
CA2793185C (en) 2010-03-16 2019-02-12 Pinnacle Spine Group, Llc Intervertebral implants and graft delivery systems and methods
US8425569B2 (en) 2010-05-19 2013-04-23 Transcorp, Inc. Implantable vertebral frame systems and related methods for spinal repair
US8518085B2 (en) 2010-06-10 2013-08-27 Spartek Medical, Inc. Adaptive spinal rod and methods for stabilization of the spine
US8377139B2 (en) 2010-06-17 2013-02-19 Aesculap Implant Systems, Llc Standalone interbody fusion device with locking and release mechanism
US8480747B2 (en) 2010-08-11 2013-07-09 Warsaw Orthopedic, Inc. Interbody spinal implants with extravertebral support plates
US8956415B2 (en) 2010-08-15 2015-02-17 Warsaw Orthopedic, Inc. Vertebral implant
US20120065734A1 (en) * 2010-09-15 2012-03-15 Spinal USA LLC Intervertebral plate system
US20120078373A1 (en) 2010-09-23 2012-03-29 Thomas Gamache Stand alone intervertebral fusion device
US11529241B2 (en) 2010-09-23 2022-12-20 DePuy Synthes Products, Inc. Fusion cage with in-line single piece fixation
US20120078372A1 (en) 2010-09-23 2012-03-29 Thomas Gamache Novel implant inserter having a laterally-extending dovetail engagement feature
US9241809B2 (en) 2010-12-21 2016-01-26 DePuy Synthes Products, Inc. Intervertebral implants, systems, and methods of use
US9211153B2 (en) 2011-01-04 2015-12-15 DePuy Synthes Products, Inc. Expansion screw bone tamp
US8454694B2 (en) 2011-03-03 2013-06-04 Warsaw Orthopedic, Inc. Interbody device and plate for spinal stabilization and instruments for positioning same
US9161794B2 (en) 2011-04-14 2015-10-20 Globus Medical, Inc. Expanding spinal anchor
US9277946B2 (en) 2011-09-06 2016-03-08 Amendia, Inc. Spinal fusion system
US9248028B2 (en) 2011-09-16 2016-02-02 DePuy Synthes Products, Inc. Removable, bone-securing cover plate for intervertebral fusion cage
US8460388B2 (en) 2011-10-28 2013-06-11 Incite Innovation Llc Spinal interbody device
US9380932B1 (en) 2011-11-02 2016-07-05 Pinnacle Spine Group, Llc Retractor devices for minimally invasive access to the spine
US9198769B2 (en) 2011-12-23 2015-12-01 Pioneer Surgical Technology, Inc. Bone anchor assembly, bone plate system, and method
US8430916B1 (en) 2012-02-07 2013-04-30 Spartek Medical, Inc. Spinal rod connectors, methods of use, and spinal prosthesis incorporating spinal rod connectors
US9271836B2 (en) 2012-03-06 2016-03-01 DePuy Synthes Products, Inc. Nubbed plate
US9566165B2 (en) 2012-03-19 2017-02-14 Amicus Design Group, Llc Interbody vertebral prosthetic and orthopedic fusion device with self-deploying anchors
US8685104B2 (en) 2012-03-19 2014-04-01 Amicus Design Group, Llc Interbody vertebral prosthetic and orthopedic fusion device with self-deploying anchors
US8814912B2 (en) 2012-07-27 2014-08-26 Zimmer Spine, Inc. Bone stabilization member with bone screw retention mechanism
WO2014028981A1 (en) * 2012-08-23 2014-02-27 Curtin University Of Technology An orthopaedic stabilisation device
US10182921B2 (en) 2012-11-09 2019-01-22 DePuy Synthes Products, Inc. Interbody device with opening to allow packing graft and other biologics
WO2014159739A1 (en) 2013-03-14 2014-10-02 Pinnacle Spine Group, Llc Interbody implants and graft delivery systems
US20140277530A1 (en) 2013-03-15 2014-09-18 Smed-Ta/Td, Llc Fixation of bone implants
US9788971B1 (en) 2013-05-22 2017-10-17 Nuvasive, Inc. Expandable fusion implant and related methods
US9801734B1 (en) 2013-08-09 2017-10-31 Nuvasive, Inc. Lordotic expandable interbody implant
USD745159S1 (en) 2013-10-10 2015-12-08 Nuvasive, Inc. Intervertebral implant
DE102014203314A1 (en) * 2014-02-25 2015-08-27 Rita Leibinger GmbH & Co. KG Surgical implant for stabilization of cervical bone
EP3151788A4 (en) 2014-06-04 2018-01-17 Wenzel Spine, Inc. Bilaterally expanding intervertebral body fusion device
USD858769S1 (en) 2014-11-20 2019-09-03 Nuvasive, Inc. Intervertebral implant
EP3250155A4 (en) 2015-01-27 2018-08-22 Spinal Elements Inc. Facet joint implant
US10940016B2 (en) 2017-07-05 2021-03-09 Medos International Sarl Expandable intervertebral fusion cage
CA3111008A1 (en) 2018-09-20 2020-03-26 Spinal Elements, Inc. Spinal implant device
US11219531B2 (en) 2019-04-10 2022-01-11 Wenzel Spine, Inc. Rotatable intervertebral spacing implant
US11857224B2 (en) * 2019-06-30 2024-01-02 Innovasis, Inc. Bone plate
US11877779B2 (en) 2020-03-26 2024-01-23 Xtant Medical Holdings, Inc. Bone plate system
WO2022077446A1 (en) * 2020-10-16 2022-04-21 暨南大学 Biologically self-locking artificial disc system kit, and method for implanting same
CN112426251A (en) * 2020-10-16 2021-03-02 暨南大学 Kit of biological self-locking artificial intervertebral disc system and implantation method thereof
US11911284B2 (en) 2020-11-19 2024-02-27 Spinal Elements, Inc. Curved expandable interbody devices and deployment tools
KR102442938B1 (en) * 2022-03-16 2022-09-14 송하정 Compression fracture restoration device for vertebral plastic surgery
KR102435969B1 (en) * 2022-03-16 2022-08-24 송하정 Compression fracture restoration implant for vertebral plastic surgery

Family Cites Families (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CH672245A5 (en) * 1987-02-02 1989-11-15 Synthes Ag Inner osteosynthesis fastener with bone screws
GB8718627D0 (en) * 1987-08-06 1987-09-09 Showell A W Sugicraft Ltd Spinal implants
FR2642958A1 (en) * 1989-02-16 1990-08-17 Louyot Comptoir Lyon Alemand SYSTEM FOR IMPLEMENTING SURGICAL INTERVENTIONS, SUCH AS THE TREATMENT OF FRACTURES OF THE VERTEBRAL COLUMN OR OF DEGENERATIVE OR TUMORAL LESIONS
SE501265C2 (en) 1993-05-07 1994-12-19 Elos Ind Ab Device for fixing vertebrae
DE4328690B4 (en) 1993-08-26 2006-08-17 SDGI Holdings, Inc., Wilmington Intervertebral implant for vertebral body blocking and implantation instrument for positioning the intervertebral implant
AU2647795A (en) * 1994-05-25 1995-12-18 American Cyanamid Company Vertebral fusion system with expandable anchor
US5681311A (en) * 1994-09-15 1997-10-28 Smith & Nephew, Inc. Osteosynthesis apparatus
DE29521456U1 (en) * 1995-12-07 1997-05-07 Aesculap Ag Orthopedic retention system
FR2747034B1 (en) * 1996-04-03 1998-06-19 Scient X INTERSOMATIC CONTAINMENT AND MERGER SYSTEM

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO9927864A2 *

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10064740B2 (en) 2003-02-06 2018-09-04 DePuy Synthes Products, LLC Intervertebral implant
US9744049B2 (en) 2007-11-16 2017-08-29 DePuy Synthes Products, Inc. Low profile intervertebral implant
US10543102B2 (en) 2007-11-16 2020-01-28 DePuy Synthes Products, Inc. Low profile intervertebral implant
US10433976B2 (en) 2008-11-07 2019-10-08 DePuy Synthes Products, Inc. Zero-profile interbody spacer and coupled plate assembly
US9848992B2 (en) 2010-12-21 2017-12-26 DePuy Synthes Products, Inc. Intervertebral implants, systems, and methods of use
US9867718B2 (en) 2014-10-22 2018-01-16 DePuy Synthes Products, Inc. Intervertebral implants, systems, and methods of use

Also Published As

Publication number Publication date
ATE272363T1 (en) 2004-08-15
AU1253199A (en) 1999-06-16
US6579290B1 (en) 2003-06-17
AU748062B2 (en) 2002-05-30
KR20010032576A (en) 2001-04-25
DE69825472D1 (en) 2004-09-09
WO1999027864A2 (en) 1999-06-10
ES2226186T3 (en) 2005-03-16
DE69825472T2 (en) 2005-08-18
WO1999027864A3 (en) 1999-09-02
JP2001524346A (en) 2001-12-04
EP1033941B1 (en) 2004-08-04

Similar Documents

Publication Publication Date Title
US6579290B1 (en) Surgical implant and surgical fixing screw
US6929662B1 (en) End member for a bone fusion implant
EP1322263B1 (en) Apparatus for stabilizing adjacent bones
US7963981B2 (en) Bone fixation plate
US8403986B2 (en) Push-in interbody spinal fusion implant with multi-lock for locking opposed screws and method for use thereof
EP1500372B1 (en) Apparatus for spinal fixation
EP1420708B1 (en) Capture-graft laminoplasty implants
JP5042014B2 (en) Bone fixation plate
EP1306058A2 (en) A surgical plate implant
JP2007532283A5 (en)
AU2001296380A1 (en) Method and apparatus for stabilizing adjacent bones
CA2435694A1 (en) Spinal or pelvic bone anchor with helical spikes
EP1148848B1 (en) End member for a bone fusion implant
CA2617889C (en) End member for a bone fusion implant
WO2022164707A1 (en) Modular apparatus for extending an existing spinal construct

Legal Events

Date Code Title Description
PUAI Public reference made under article 153(3) epc to a published international application that has entered the european phase

Free format text: ORIGINAL CODE: 0009012

17P Request for examination filed

Effective date: 20000608

AK Designated contracting states

Kind code of ref document: A2

Designated state(s): AT BE CH CY DE DK ES FI FR GB GR IE IT LI LU MC NL PT SE

17Q First examination report despatched

Effective date: 20020307

GRAP Despatch of communication of intention to grant a patent

Free format text: ORIGINAL CODE: EPIDOSNIGR1

GRAS Grant fee paid

Free format text: ORIGINAL CODE: EPIDOSNIGR3

GRAA (expected) grant

Free format text: ORIGINAL CODE: 0009210

AK Designated contracting states

Kind code of ref document: B1

Designated state(s): AT BE CH CY DE DK ES FI FR GB GR IE IT LI LU MC NL PT SE

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: NL

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20040804

Ref country code: LI

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20040804

Ref country code: FI

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20040804

Ref country code: CY

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20040804

Ref country code: CH

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20040804

Ref country code: BE

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20040804

Ref country code: AT

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20040804

REG Reference to a national code

Ref country code: GB

Ref legal event code: FG4D

REG Reference to a national code

Ref country code: CH

Ref legal event code: EP

REG Reference to a national code

Ref country code: SE

Ref legal event code: TRGR

REG Reference to a national code

Ref country code: IE

Ref legal event code: FG4D

REF Corresponds to:

Ref document number: 69825472

Country of ref document: DE

Date of ref document: 20040909

Kind code of ref document: P

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: GR

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20041104

Ref country code: DK

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20041104

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: LU

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20041127

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: IE

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20041129

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: MC

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20041130

NLV1 Nl: lapsed or annulled due to failure to fulfill the requirements of art. 29p and 29m of the patents act
REG Reference to a national code

Ref country code: CH

Ref legal event code: PL

REG Reference to a national code

Ref country code: ES

Ref legal event code: FG2A

Ref document number: 2226186

Country of ref document: ES

Kind code of ref document: T3

ET Fr: translation filed
PLBE No opposition filed within time limit

Free format text: ORIGINAL CODE: 0009261

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: NO OPPOSITION FILED WITHIN TIME LIMIT

26N No opposition filed

Effective date: 20050506

REG Reference to a national code

Ref country code: IE

Ref legal event code: MM4A

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: PT

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20050104

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: ES

Payment date: 20111124

Year of fee payment: 14

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: SE

Payment date: 20130531

Year of fee payment: 15

Ref country code: DE

Payment date: 20130529

Year of fee payment: 15

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: FR

Payment date: 20130617

Year of fee payment: 15

Ref country code: IT

Payment date: 20130529

Year of fee payment: 15

REG Reference to a national code

Ref country code: DE

Ref legal event code: R081

Ref document number: 69825472

Country of ref document: DE

Owner name: MANDACO 569 LTD., REDDITCH, GB

Free format text: FORMER OWNER: SURGICRAFT LTD., REDDITCH, GB

Effective date: 20130723

Ref country code: DE

Ref legal event code: R081

Ref document number: 69825472

Country of ref document: DE

Owner name: MANDACO 569 LTD., GB

Free format text: FORMER OWNER: SURGICRAFT LTD., REDDITCH, GB

Effective date: 20130723

REG Reference to a national code

Ref country code: SE

Ref legal event code: EUG

REG Reference to a national code

Ref country code: GB

Ref legal event code: 732E

Free format text: REGISTERED BETWEEN 20140717 AND 20140723

REG Reference to a national code

Ref country code: FR

Ref legal event code: ST

Effective date: 20140731

REG Reference to a national code

Ref country code: DE

Ref legal event code: R119

Ref document number: 69825472

Country of ref document: DE

Effective date: 20140603

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: IT

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20131127

Ref country code: DE

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20140603

Ref country code: SE

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20131128

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: FR

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20131202

REG Reference to a national code

Ref country code: ES

Ref legal event code: FD2A

Effective date: 20150407

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: ES

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20131128

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: GB

Payment date: 20161026

Year of fee payment: 19

GBPC Gb: european patent ceased through non-payment of renewal fee

Effective date: 20171127

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: GB

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20171127